Planning Future Strategies for Domestic and International NeuroAIDS Research, July 24–25, 2008

Journal of Neuroimmune Pharmacology (Impact Factor: 4.11). 09/2009; 4(3):283-297. DOI: 10.1007/s11481-009-9159-1
Source: PubMed


The National Institute of Mental Health in cooperation with the National Institute on Drug Abuse and the National Institute
of Neurological Disorders and Stroke organized a meeting on July 24–25, 2008 to develop novel research directions for neuroAIDS
research. The deliberations of this meeting are outlined in this brief report. Several critical research areas in neuroAIDS
were identified as areas of emphasis. Opportunities for collaborations between large NIH-funded projects were also discussed.

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Available from: David B Clifford, Feb 03, 2014
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    • "Finally, current criteria for initiation of HAART do not consider CNS outcomes as a benchmark of efficacy, thus establishing CNSbased criteria for initiation of protocols should be the ultimate goal not only for therapeutic but also for neuroprotection strategies ; as recently stated by Jeymohan et al. (2009) on behalf of the NeuroAIDS research participants these priorities should be seen as a template for future growth of the field and its long-term impact. "
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    ABSTRACT: THE CENTRAL NERVOUS SYSTEM (CNS) REPRESENTS AN IMPORTANT TARGET FOR HIV INFECTION DURING MULTIPLE STAGES OF THE DISEASE: early, after invasion of the host, acting as a viral reservoir; lately, subverting its function and causing peripheral neuropathies and neurocognitive disorders; and lastly, during the final stage of NeuroAIDS, triggering opportunistic infections, cancers, and dementia. Highly active antiretroviral therapy, a combination of drugs that inhibits enzymes essential for HIV replication, can reduce the viremia and the onset of opportunistic infections in most patients, and prolong the survival. Among the limits of the current treatments the most noticeable is the inability to eradicate HIV-infected cells, both, limiting the time frame in which antiretroviral therapies initiated after exposure to HIV can prevent infection, and allowing replication-competent virus that persists in infected cells to emerge rapidly after the cessation of treatments. Many strategies are currently under evaluation to improve HIV treatment, unfortunately more than 98% of drug candidates for CNS disorders never make it to the clinic; here in we report how nanoformulated strategies might be adapted and applied to the field of CNS-HIV infection.
    Full-text · Article · Mar 2012 · Frontiers in Neurology
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    • "HIV-1 associated dementia (HAD) is a common complication of HIV disease with a prevalence of at least 20% in advanced HIV infection in the pre-highly active antiretroviral therapy (HAART) era [1]. Even in patients taking HAART, milder forms of cognitive impairment remain common and functionally significant [2]. The reasons for the continued presence and development of HAD and its milder forms, despite effective HAART are not clear. "
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    ABSTRACT: The pathogenesis of HIV-associated dementia (HAD) is poorly understood. To date, detailed proteomic fingerprinting directly from autopsied brain tissues of HAD and HIV non-dementia patients has not been performed. Here, we have analyzed total proteins from the frontal cortex of 9 HAD and 5 HIV non-dementia patients. Using 2-Dimensional differential in-gel electrophoresis (2-DIGE) to analyze the brain tissue proteome, 76 differentially expressed proteins (p < 0.05; fold change>1.25) were identified between HAD and HIV non-dementia patients, of which 36 protein spots (based on 3D appearance of spots on the images) were chosen for the mass spectrometry analysis. The large majority of identified proteins were represented in the energy metabolic (mitochondria) and signal transduction pathways. Furthermore, over 90% of the protein candidates are common to both HAD and other non-viral neurodegenerative disease, such as Alzheimer's disease. The data was further validated using specific antibodies to 4 proteins (CA2, GS, CKMT and CRMP2) by western blot (WB) in the same samples used for 2D-DIGE, with additional confirmation by immunohistochemitsry (IHC) using frontal lobe tissue from different HAD and HIV+ non-dementia patients. The validation for all 4 antibodies by WB and IHC was in concordance with the DIGE results, lending further credence to the current findings. These results suggest not only convergent pathogenetic pathways for the two diseases but also the possibility of increased Alzheimer's disease (AD) susceptibility in HAD patients whose life expectancy has been significantly increased by highly active antiretroviral therapy.
    Full-text · Article · Jun 2010 · Molecular Neurodegeneration
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    ABSTRACT: HIV-Associated Neurocognitive Disorders (HAND) exert an impact on everyday functions, including adherence. The prevalence of and risk factors for HAND in patients commencing anti-retroviral therapy in Southern Africa are unknown. Participants from primary care clinics in Cape Town, South Africa underwent detailed neuropsychological, neuropsychiatric, and neuromedical evaluation. Using the updated American Academy of Neurology (AAN) criteria, participants were classified into categories of HAND, and demographic and clinical risk factors for HIV-dementia (HIV-D) were assessed. The prevalence of mild neurocognitive disorder (MND) and HIV-D were 42.4 and 25.4%, respectively. There were significant associations between lower levels of education and older age with HIV-D, and a trend to association with HIV-D and lower CD4 count. In a regression model, a lower level of education and male gender were predictive of HIV-D. These findings suggest that HAND are highly prevalent in primary care settings in South Africa where clade C HIV is predominant.
    No preview · Article · Aug 2011 · AIDS and Behavior
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